Scoliosis and the side plank exercise

There was a lot of excitement in the scoliosis community last year when this news came out: “A single yoga pose each day may improve spine curvature for scoliosis patients”. The news was also discussed in length here – with many interesting comments.

A scientific study has been carried out (original article here) investigating the effects of the so-called side plank yoga exercise on scoliosis. The study included 25 participants with scoliosis. The idea was to investigate the effect of asymmetrical strengthening and appears to focus primarily on C-curve scoliosis as opposed to S-curves – even though this is not clearly stated in the article. This is a pity, as the majority of scoliosis cases are S-curves rather than C-curves.

The side plank exercise is a yoga exercise – see picture below. It is a variation of the normal plank exercise where you build strength by assuming the position of a push-up for the maximum period of time.

Each participant was instructed to hold the side plank posture on the convex side (what’s that on an S curve?) – daily, and for as long as possible. In the study this was around 1.5 minutes a day for 6.1 days a week.

Amazingly, over a 6.8-month period, for 19 of the 25 participants, measurements indicated a reduction of curvature of 40.9% on average.

With my wife a long time sufferer of scoliosis and also an eager yoga practitioner, we immediately studied the research results in detail. My wife has an S-curve and the study doesn’t clearly state whether patients with S-curves are included. If indeed it does include S-curves, we also wondered which side is the convex side for an S-curve???

We wrote an email to Dr. Loren Fishman, one of the authors of the study. He responded back that yes – the exercise would also work for S-curves but with no clear indication of how to carry out the exercise with an S-curve. We assumed that the focus should be on the lumbar curve which is traditionally viewed as the primary curve by Schroth physicians and others. So my wife took to carrying out the exercise according to the convex side of her lumbar curve.

Unfortunately – for her – done in this fashion – the exercise had no positive effects. Rather she had increasing back and neck pain as a result.

Soon after the publishing of the study, pilates instructor Erin Myers published a highly skeptical review here.

She argues convincingly that the exercises in the study were done on the wrong side! She further references the Schroth reference book:

which also contradicts the study and states that the exercise should be done with the concave side facing downward rather than the convex. Myers goes into a detailed explanation of human muscles and argues convincingly that the exercise carried out in the study could hardly have produced such surprisingly good results.

She highlights other weak points of the study, i.e., that the study is based on a sample of only 19 patients with very different types of scoliosis, very different age groups, very different magnitude of curves and very different intervals of time. Furthermore seven different variations of the exercise was done.

However, as Myers notes at the end – the study does report very significant findings – in spite of all the potential issues – doing 1.5 minutes of a potentially incorrect exercise every day.

Since the above debate, the researchers have clarified that the study did indeed focus on the lumbar curve for S-curves and they maintain that the convex side should indeed be facing downwards.

Dr. Loren Fishman is an MD who is specialized in Iyengar yoga. Here is a link to one of his articles. On this page he responds to questions regarding the exercise. He mentions that they are planning to do a larger study and we really look forward to that. Hopefully it can quench the skepticism and bring hope for scoliosis patients world-wide.

And finally – it is worth highlighting again that Dr. Fishman recommends to have the convex side facing downwards. For S-curves (and C-curves), the convex side is the side that is pushed out and will often be more solid than the other side.

We will keep track of further research and clarification in this area.